<div class="box box-primary" xmlns:th="http://www.thymeleaf.org">
	<div class="box-header with-border">
		<h3 class="box-title">费用信息</h3>
	</div>

	<form id="costForm1" class="form-horizontal">
		<input id="type" type="hidden" th:value="${type}"/>
		<input id="costId" type="hidden" th:value="${costId}"/>
		<div class="box-body">
			<div class="form-group">
				<label class="col-md-2 control-label">医院名称<span class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<select id="hospital" name="hospital_id" bindname="hospital_id" btvd-type="required"
						btvd-class='btvdclass' ></select>
				</div>
				<label class="col-md-2 control-label">科室名称<span class="colorred" >*</span>：
				</label>
				<div class="col-md-4">
					<select id="department" name="department_id" bindname="department_id" btvd-type="required"
						btvd-class='btvdclass' ></select>
				</div>
			</div>
			<div class="form-group">
				<label class="col-md-2 control-label">医生名称<span class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<select id="user" name="doc_id" bindname="doc_id" btvd-type="required"
						btvd-class='btvdclass' ></select>
				</div>
			</div>
			<div class="form-group">
				<label class="col-md-2 control-label">费用<span class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<input id="cost1" class="form-control" type="text" name="cost" bindname="cost" btvd-type="required"
						btvd-class='btvdclass' />
				</div>
				<label class="col-md-2 control-label">管理费<span  class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<input id="manager" class="form-control" type="text" name="manager_cost" bindname="manager_cost" btvd-type="required"
						btvd-class='btvdclass' />
				</div>
			</div>
			
		</div>
		<div class="box-footer">
			<button id="cancel" type="button" class="btn btn-default pull-right">取消</button>
			<button id="save" type="button" class="btn btn-info pull-right mr30">保存</button>
		</div>
	</form>
</div>
<script th:if="${projectModel=='dev'}" th:src="@{/static/js/business/cost/form.js(v=${#dates.createNow().getTime()})}"></script>
<script th:if="${projectModel=='product'}" th:src="@{/static/js/business/cost/form.js}"></script>